• 임상간호연구
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• 제30권1호
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• pp.35-44
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• 2024

Purpose: The purpose of this study is to compare the predictive validity of pressure injury risk assessment, Braden, Braden Q and Braden QD for pediatric patients. Methods: Prospective observational study included patients under the age of 19 who were hospitalized to general wards, intensive care units of a children's hospital. Characteristics related to pressure injury were collected, and predicted validity was compared by calculating the areas under the curve (AUC) of the Braden, Braden Q, and Braden QD scales. Results: A total of 689 patients were included in the study. A total of 13 (1.9%) patients had pressure injuries, and the number of pressure injuries was 17. Factors related to the occurrence of pressure injuries were 9 (52.9%) immobility-related and 8 (47.1%) medical device-related. The AUC for each scale was .91 (95% CI .89~.94) for Braden, .92 (95% CI .90~.95) for Braden Q, and .94(95% CI .92~.96) for Braden QD. The optimal cut-off points were identified as 16 for Braden (sensitivity=88.8%, specificity=86.4%), 17 for Braden Q(sensitivity=63.6%, specificity=94.9%), and 12 for Braden QD (sensitivity=94.4%, specificity=88.7%). Conclusion: The Braden QD scale demonstrated the highest predictive validity for pressure injuries in pediatric patients and is expected to be valuable tool in preventing pediatrics pressure injuries.

• Radiation Oncology Journal
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• 제37권3호
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• pp.149-155
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• 2019

In metastatic non-small cell lung cancer (NSCLC), the role of radiotherapy (RT) has been limited to palliation to alleviate the symptoms. However, with the development of advanced RT techniques, recent advances in immuno-oncology therapy targeting programmed death 1 (PD-1) and programmed death ligand 1 (PD-L1) and targeted agents for epidermal growth factor receptor (EGFR) mutation or anaplastic lymphoma kinase (ALK) translocation allowed new roles of RT in these patients. Within this metastatic population, there is a subset of patients with a limited number of sites of metastatic disease, termed as oligometastasis that can achieve long-term survival from aggressive local management. There is no consensus on the definition of oligometastasis; however, most clinical trials define oligometastasis as having 3 to 5 metastatic lesions. Recent phase II randomized clinical trials have shown that ablative RT, including stereotactic ablative body radiotherapy (SABR) and hypofractionated RT, to primary and metastatic sites improved progression-free survival (PFS) and overall survival (OS) in patients with oligometastatic NSCLC. The PEMBRO-RT study, a randomized phase II study comparing SABR prior to pembrolizumab therapy and pembrolizumab therapy alone, revealed that the addition of SABR improved the overall response, PFS, and OS in patients with advanced NSCLC. The efficacy of RT in oligometastatic lung cancer has only been studied in phase II studies; therefore, large-scale phase III studies are needed to confirm the benefit of local ablative RT in patients with oligometastatic NSCLC. Local intensified RT to primary and metastatic lesions is expected to become an important treatment paradigm in the near future in patients with metastatic lung cancer.

• The Korean Journal of Pain
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• 제5권2호
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• pp.258-262
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• 1992

1991년 3월 부터 1992년 2월까지 부산대학교병원 통증치료실에 내원한 27명의 대상포진후 신경통 환자를 대상으로 하여 저출력 레이저의 치료효과를 관찰한 바를 아래와 같이 요약한다. 1) 주된 병소부위는 흉추신경분포부위이었다. 2) 70세 미만의 환자에서는 VAS의 개선율이 57%로 효과가 있었으나, 70세 이상의 환자에서는 VAS 개선율이 27%로 현저히 감소하였다. 3) 발병후 치료시간 까지의 기간이 1개월 이내인 환자는 저출력 레이저에 의한 치료효과가 좋았으나, 12개월이상 경과한 환자는 치료효과가 좋지 않았다. 4) 발병후 1개월이내에 치료를 실시한 환자의 VAS개선율이 50%가 되기까지의 평균 조사횟수는 5.7회이었다.

• 대한소아치과학회지
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• 제41권2호
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• pp.134-144
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• 2014

본 연구는 환자분포 및 치료경향을 조사하여 소아치과의 변화하는 진료 양상을 알기 위해 시행하였다. 2008년 1월부터 2012년 12월까지 연세대학교 치과대학병원 소아치과에 내원한 환자를 대상으로 전자의무기록을 수집하고 분석하였다. 조사 결과 초진환자와 비선택 진료의사 1인당 환자 수는 감소하였고 외국인 환자수가 급증하였다. 신환은 만 0~2세의 연령층이 가장 많았고, 내원 주소는 치아우식증, 외상, 부정교합 순으로 높게 나타났다. 수복치료의 분포 결과 복합레진 수복, 아말감 수복, 치면열구전색술은 감소하였고, 자가중합형 글라스아이오노머, 예방적 레진수복이 증가하는 추세였다. 다내원근관치료가 감소하고 당일발수 근관 충전이 증가했으며, 치수복조술과 치수절단술과 같은 보존적 치수치료의 비율이 증가하였다. 환자의 불안을 감소시키기 위해 진정법을 선택하는 경우가 증가하였으며 아산화질소의 이용이 주를 이루었다. 내원 환자의 분포 및 특성을 파악하고, 최신 치료 경향을 제공함으로써 환자의 요구에 부합하는 적절한 치료계획을 수립하는데 도움이 될 것으로 생각된다.

• 한국빅데이터학회지
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• 제6권1호
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• pp.37-49
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• 2021

한국의 치매 환자 수는 80만명 이상으로 추정되고 있으며, 치매의 심각성은 사회적 문제로 되고 있다. 하지만 전 세계적으로 치매를 완치할 수 있는 치료법도 약물도 아직 개발되지 못하고 있으며, 향후 급격한 고령화 추세로 인해 치매 환자 수는 더욱 증가할 전망이다. 현재로서는 치매를 조기에 발견하여 치매 증상의 경과를 늦추는 것이 최적의 대안이라 할 수 있다. 본 연구에서는 망막 내 치매를 가장 명확하게 조기 진단할 수 있는 중요 단백질인 아밀로이드 플라크를 AI 기반의 영상분석을 통해 측정하고 분석하여 치매를 조기에 진단하는 방법론을 제시하였다. 망막 데이터를 CNN을 기반으로 이진분류 학습 및 다중분류 학습을 수행하였으며, 전처리 된 망막 데이터를 기반으로 치매를 조기 진단할 수 있는 딥러닝 알고리즘을 개발하였다. 딥러닝 모델에 대한 정확도와 재현율을 검증하였으며, 검증 결과 재현율과 정확도 모두 충족하는 결과를 도출하였다. 향후에는 실제 치매 환자의 임상데이터를 기반으로 연구를 지속해 나갈 계획이며, 본 연구의 결과는 치매 문제를 해결하는 방안으로 활용될 수 있다.

• IMMUNE NETWORK
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• 제22권1호
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• pp.3.1-3.21
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• 2022

Cancer is one of the leading causes of death worldwide and the number of cancer patients is expected to continuously increase in the future. Traditional cancer therapies focus on inhibiting cancer growth while largely ignoring the contribution of the immune system in eliminating cancer cells. Recently, better understanding of immunological mechanisms pertaining to cancer progress has led to development of several immunotherapies, which revolutionized cancer treatment. Nonetheless, only a small proportion of cancer patients respond to immunotherapy and maintain a durable response. Among multiple factors contributing to the variability of immunotherapy response rates, commensal microbiota inhabiting patients have been identified as one of the most critical factors determining the success of immunotherapy. The functional diversity of microbiota differentially affects the host immune system and controls the efficacy of immunotherapy in individual cancer patients. Moreover, clinical studies have demonstrated that changing the gut microbiota composition by fecal microbiota transplantation in patients who failed a previous immunotherapy converts them to responders of the same therapy. Consequently, both academic and industrial researchers are putting extensive efforts to identify and develop specific bacteria or bacteria mixtures for cancer immunotherapy. In this review, we will summarize the immunological roles of commensal microbiota in cancer treatment and give specific examples of bacteria that show anticancer effect when administered as a monotherapy or as an adjuvant agent for immunotherapy. We will also list ongoing clinical trials testing the anticancer effect of commensal bacteria.

• 한국보건간호학회지
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• 제31권1호
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• pp.5-18
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• 2017

Purpose: This study was conducted to suggest a method for financial projection of health insurance expenditures that reflects future changes in demographic structure. Methods: Using data associated with the number of patients and health insurance cost per patient, generalized linear models (GLM) were fitted with demographic explanatory variables. Models were constructed separately for individual medical departments, types of medical service, and types of public health insurance. Goodness-of-fit of most of the applied GLM models was quite satisfactory. By combining estimates of frequency and severity from the constructed models and results of the population projection, total annual health insurance expenditures were projected through year 2060. Results: Expenditures for medical departments associated with diseases that are more frequent in elderly peoples are expected to increase steeply, leading to considerable increases in overall health insurance expenditures. The suggested method can contribute to improvement of the accuracy of financial projection. Conclusion: The overall demands for medical service, medical personnel, and relevant facilities in the future are expected to increase as the proportion of elderly people increases. Application of a more reasonable estimation method reflecting changes in demographic structure will help develop health policies relevant to above mentioned resources.

• 대한치과의사협회지
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• 제47권5호
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• pp.291-296
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• 2009

Purpose : The aim of this studγ was to evaluate the patient's and dentist's perspective and knowledge on rapid human immunodeficiency virus screening test in dental setting. Material and Methods: In March 2009, 100 patients and 100 dentists at College of Dentistry, Yonsei University were provided an attitude assessment survey. Results : Results were analyzed for acceptance of testing and potential barriers. 94% of patients agreed to take a rapid HIV screening test and 77% of dentists were willing to provide the test to their patients. Also the current knowledge state of patients and dentists on HIV infection was not accurate as expected. Conclusion : Overall, dental clinic patients widely accepted the offer of rapid oral HIV screening. Rapid HIV screening test in the dental setting ran be an important option to increase the number of individuals who know their HIV status.

• BMB Reports
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• 제56권5호
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• pp.308-313
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• 2023

Phenotypic features such as ataxia and loss of motor function, which are characteristics of Parkinson's disease (PD), are expected to be very closely related to cerebellum function. However, few studies have reported the function of the cerebellum. Since the cerebellum, like the cerebrum, is known to undergo functional and morphological changes due to neuroinflammatory processes, elucidating key functional factors that regulate neuroinflammation in the cerebellum can be a beneficial therapeutic approach. Therefore, we employed PD patients and MPTP-induced PD mouse model to find cytokines involved in cerebellar neuroinflammation in PD and to examine changes in cell function by regulating related genes. Along with the establishment of a PD mouse model, abnormal shapes such as arrangement and number of Purkinje cells in the cerebellum were confirmed based on histological finding, consistent with those of cerebellums of PD patients. As a result of proteome profiling for neuroinflammation using PD mouse cerebellar tissues, fetuin-A, a type of cytokine, was found to be significantly reduced in Purkinje cells. To further elucidate the function of fetuin-A, neurons isolated from cerebellums of embryos (E18) were treated with fetuin-A siRNA. We uncovered that not only the population of neuronal cells, but also their morphological appearances were significantly different. In this study, we found a functional gene called fetuin-A in the PD model's cerebellum, which was closely related to the role of cerebellar Purkinje cells of mouse and human PD. In conclusion, morphological abnormalities of Purkinje cells in PD mice and patients have a close relationship with a decrease of fetuin-A, suggesting that diagnosis and treatment of cerebellar functions of PD patients might be possible through regulation of fetuin-A.

• Journal of Korean Neurosurgical Society
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• 제56권1호
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• pp.28-33
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• 2014

Objective : Postoperative delirium is a common complication in the elderly after surgery but few papers have reported after spinal surgery. We analyzed various risk factors for postoperative delirium after spine surgery. Methods : Between May 2012 and September 2013, 70 patients over 60 years of age were examined. The patients were divided into two groups : Group A with delirium and Group B without delirium. Cognitive function was examined with the Mini-Mental State Examination-Korea (MMSE-K), Clinical Dementia Rating (CDR) and Global Deterioration Scale (GDS). Information was also obtained on the patients' education level, underlying diseases, duration of hospital stay and laboratory findings. Intraoperative assessment included Bispectral index (BIS), type of surgery or anesthesia, blood pressure, fluid balance, estimated blood loss and duration of surgery. Results : Postoperative delirium developed in 17 patients. The preoperative scores for the MMSE, CDR, and GDS in Group A were $19.1{\pm}5.4$, $0.9{\pm}0.6$, and $3.3{\pm}1.1$. These were significantly lower than those of Group B ($25.6{\pm}3.4$, $0.5{\pm}0.2$, and $2.1{\pm}0.7$) (p<0.05). BIS was lower in Group A ($30.2{\pm}6.8$ compared to $35.4{\pm}5.6$ in group B) (p<0.05). The number of BIS <40 were $5.1{\pm}3.1$ times in Group A, $2.5{\pm}2.2$ times in Group B (p<0.01). In addition, longer operation time and longer hospital stay were risk factors. Conclusion : Precise analysis of risk factors for postoperative delirium seems to be more important in spinal surgery because the surgery is not usually expected to have an effect on brain function. Although no risk factors specific to spinal surgery were identified, the BIS may represent a valuable new intraoperative predictor of the risk of delirium.